经腋中线胸腔入路手术切除上中胸椎肿瘤的临床疗效分析

发布时间：2018-04-21 08:30

本文选题：经腋中线 + 上中胸椎肿瘤　；参考：《广西医科大学》2015年硕士论文

【摘要】：目的：探讨经腋中线胸腔入路手术治疗上中胸椎肿瘤手术方式及临床疗效分析。方法：1、按选入标准选取2012年2月至2014年12月在我科住院手术的上中胸椎肿瘤(T2-T6)患者7例。采用经腋中线胸腔入路肿瘤病灶切除,植骨融合,钛笼钛板内固定治疗。观察手术切口长度、术野显露、出血量、手术时间、神经减压情况、胸腔引流量、术后并发症情况,以及术前、术后随访Frankel评分、VAS评分情况。术后随访2-27个月。2、通过SPSS21.0对数据进行分析,检验数据是否正态时检验水准为a=0.1,当p0.1时数据呈正态分布；其余数据统计对比检验水准为a=0.05,当p0.05时有统计学差异。结果：全部7例患者均能通过腋中线胸腔入路顺利完成上中胸椎椎体的显露和病灶切除以及完成椎体间的植骨融合和钛笼钛板内固定的植入。该入路显露范围可达T1下缘至T7上缘,能够对T2-T6的病灶进行相应的手术操作,未出现术中及术后并发症。患者在术后随访中VAS评分和Frankel神经功能分级均有一定程度的改善,有统计学差异(P0.05)。结论：经腋中线胸腔入路治疗上中胸椎椎体肿瘤具有视野开阔,病变节段显露清楚,病灶清除彻底,内固定操作简易,神经减压满意,固定牢靠,并发症少等优点,具有实践价值,是手术治疗上中胸椎椎体肿瘤的一种新的思路。
[Abstract]:Objective: To investigate the surgical methods and clinical effects of thoraco thoracic surgery in the treatment of upper and middle thoracic tumors. Methods: 1, 7 cases of upper middle thoracic tumors (T2-T6) were selected from February 2012 to December 2014 in our department in accordance with the selection criteria. The tumor resection, bone fusion, titanium cage titanium plate and titanium cage were used. Fixed treatment. Observation of surgical incision length, operation field exposure, bleeding volume, operation time, nerve decompression, thoracic drainage, postoperative complications, and preoperative, follow-up Frankel score, VAS score, 2-27 months after the operation.2, the data were analyzed by SPSS21.0, the test data were normal when the test level was a=0.1, when p, when p At 0.1, the data showed a normal distribution; the rest of the data was a=0.05, and there was a statistical difference when P0.05. Results: all the 7 patients were able to successfully complete the upper middle thoracic vertebral body exposure and the lesion resection through the midline thoracic approach, and complete the interbody fusion and titanium cage titanium plate internal fixation. The exposure range can reach the lower edge of T1 to the upper edge of T7, and it can operate on the T2-T6 focus. There is no intraoperative and postoperative complications. The VAS score and the Frankel nerve function grade are improved to a certain extent in the postoperative follow-up, and there are statistical differences (P0.05). Conclusion: midline thoracic approach is used to treat the upper and middle thoracic vertebral body swollen. The tumor has a wide field of vision, clear lesion segment, thorough clearing of the lesion, simple internal fixation, satisfactory nerve decompression, fixed fixation, less complications and so on. It is of practical value. It is a new idea for the surgical treatment of upper thoracic vertebra tumor.

【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R738

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